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Vigilance essential, doctors tell parents

Common signs indicate flu danger for children

Max Gomez, 5, died in August, apparently of swine flu. Max Gomez, 5, died in August, apparently of swine flu.
By Lindsey Tanner
Associated Press / October 13, 2009

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CHICAGO - Max Gomez was a bright-eyed 5-year-old happy to have just started kindergarten when he developed sniffles and a fever. His mother figured it was only a cold.

Three days later, the Antioch, Tenn., boy was dead, apparently from swine flu.

At least 76 American children have died from the new virus, and doctors are urging parents to watch for warning signs that the flu has become life-threatening.

Ruth Gomez says Max developed dangerous symptoms - bluish fingers and extreme fatigue after seeming to get better - just one day before he died. She took him to the doctor, but it was too late.

“We were in shock,’’ said Gomez, who is still trying to understand the death of her little on Aug. 31. “There are so many unanswered questions.’’

It is a question on other parents’ minds, too: How can they protect their children from swine flu until the vaccine is widely available?

Swine flu has probably infected hundreds of thousands of youngsters nationwide, but deaths among children are rare. Health officials are keeping track of children’s flu deaths, but they say it is impossible to count all flu cases. So they don’t know what percentage of children’s infections are fatal.

Many specialists say the H1N1 virus does not appear to be more dangerous than other flu strains, but children have been catching it more easily than seasonal flu.

Last week there were 19 reports of children who died, according to the federal Centers for Disease Control and Prevention. And the 76 swine flu fatalities since April compare with 68 pediatric deaths from seasonal flu since September 2008.

Because children seem so vulnerable to it, “every medical epidemiologist in the country’’ is tracking how it affects them, said Dr. Susan Gerber, an associate medical officer for the public health department in Cook County, Ill.

Most children will recover, but “it’s still very concerning and needs to be watched very closely’’ Gerber said.

Dr. Kenneth Alexander, the University of Chicago’s pediatric infectious disease chief, said there are common signs to indicate when both kinds of flu turn dangerous.

Flu viruses can damage cilia, the hair-like fibers lining the respiratory tract that move bacteria and mucous “where we can cough them out’’ of the lungs, he explained.

That can make people susceptible to pneumonia and other bacterial infections - a scenario blamed for many flu deaths in otherwise healthy children and adults, he said. In these cases, flu patients often appear to get better, but then fever and a cough return. Authorities urge parents to seek immediate help if emergency warning signs develop. In children, these are:

■ Fast or troubled breathing; bluish skin color; lack of thirst.

■ Failure to wake up easily or interact; irritability so that the child does not want to be held.

■ Improvement of symptoms, then a return to fever and worse cough; fever with a rash.

A recent report from the CDC found that one-third of pediatric deaths from the H1N1 virus were in children like Max, with no known underlying condition that would put them at risk.

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